Julie Cohen is a licensed Marriage and Family Therapist MFT and a Child Mental Health Specialist with a private practice in Los Angeles. Her areas of focus include: depression, anxiety, panic, post-traumatic stress, bipolar…

Stepping into a therapist's office for the first time takes courage. In fact, the decision can be so stressful that some people wait until they are in crisis and/or have exhausted all others ways of trying to solve their problems. But, once on the "couch," relief sets in as they realize that therapy is a worthwhile investment of time and money. Yet, often a client may unknowingly sabotage their own treatment.

Freud called this "resistance." While resistance does occur, I have found that some client's just don't understand how to make the most out of their therapy sessions. Even a well trained therapist can't detour a client from wasting valuable session time if that client is determined (consciously or unconsciously) to talk about everything other than the core issues that brought them to therapy in the first place.

Now it is normal for client's to veer off track from time to time and adjunct stories are often a relevant part of the therapeutic process. However, taking a mindful and focused approach to your therapy may help you resolve issues sooner and leave therapy with a higher degree of satisfaction. To get you on the road to productive psychotherapy check out these 5 things never to tell your shrink:

1. " Fix me!" Part of the healing process involves accountability. If you walk into a therapist's office expecting them to do all the work you will leave sorely disappointed. Of course, a therapist should take an active role in the therapy but as a client you need to take an equally active role. Take the approach that therapy is work and that you have a job to do.

2 Random stories: One of my most respected mentors told me that ". . . your clients will take you on a walk in the garden and show you all the flowers and do everything they can to avoid talking about why they are really there. In other words: Avoidance. Time is money, especially in therapy. And therapy is not cheap. Some shrinks charge upwards of $200 per 50 minute session. So, make every minute count! Catch yourself if you start to drift of topic. Your therapist may be very skilled at corralling you back but do you really want to spend your entire session having your shrink chase you down? If you notice yourself veering off tell your therapist that you are having a hard time staying focused. Sharing that with your therapist could lead to an insightful and meaningful session.

3. "You haven't helped me:" Now granted there are a few just plain old bad therapists out there but generally most therapists are well trained and put effort and skill into helping clients resolve their issues. If you have spent a lot of time in therapy with a competent therapist without noticing progress you may need to look in the mirror versus pointing a finger towards your shrink. Your therapist may be giving you wonderful tools but if you don't implement them they become meaningless. Remember your work doesn't stop when the 50 minutes are up. Also, if you do try to implement the tools but are unsuccessful, let your therapist know so the two of you can rework them.

4. "Let's have lunch:" A therapist/client relationship is unique. It can feel like a good friendship except that one friend never talks about themselves. If you were to socialize with your therapist it would taint your work together. Successful therapy depends on the therapist having a neutral stance and remaining a bit of an outsider in your social world. It doesn't mean that a therapist doesn't care about you. On the contrary, most are totally invested in you getting well that they would never jeopardize the therapy by crossing that line.

5. "Tell me about your problems:" A therapist must be careful what they self-disclose to their clients. If they share too much about themselves the therapy then becomes about the therapist and not the client. If you are dying to know personal information about your therapist there may be an underlying reason. And uncovering that reason may be valuable to the therapy. Have a discussion about your interest in knowing personal information about your therapist rather than the personal information itself. That way the work will stay focused on you.

So many of the "drs" on here complain about how their pts do all kinds of crap wrong when going to accourding to these drs pretty much waste their time. If you hate your job FIND A NEW ONE!!!!!! There a million things I could do and say that drs and a bunch of other people do to piss me off on a daily basis but you know this is a webside looking to give ppl strength and courage. Writing about how the people that spend THIER hard erned cash to just waste your time and find out whats wrong with them is insane, rude, and exstreamly shamful on your part. STOP WITH ALL THE NEG "YOU DO THIS AND THAT WRONG SO IM GOING TO TELL YOU ABOUT IT" CRAP!!!!!!!!!!!!

I have to take exception to #3. I have been to many therapists over 30 years, and have studied extensively the realities of the therapy profession (all types, Pyschs, Psycho, LCSW, Blah blah). It is well documented that there is a large portion of mental health practitioners that never resolved enough of there own issues to be effective. Over the last 30 years, I would say that about 35% had no business being in the mental health profession- and about 10% in fact did more damage then good. I've even had one fall asleep during our second session as I was talking being raped by a parent as a child. On the other side of the coin, I would say about 25% were insanely good and caring, truly engaged- while the remaining were good and engaged. I dont think that stats are all that different then any other profession, but #3 sets people up to not stand up for themselves. Yes, I agree, you need to start by taking a hard look in the mirror. But if your gut is telling your this doesnt feel safe or positive, whether its the therapists fault or not- move and find someone who you do click with. Claim your journey.

The only thing that I take issue with is when a therapist won't answer a single question about themselves, even a simple one. I have known at least one to get upset and authoritarian when asked something about herself. Problem is: it's harder to trust a person who gets their back up when you ask about them but they want you to hold nothing back, and it can make one feel like they are being patronized. I agree that there should be very little of the therapist sharing from their life, but sometimes I think it can really help a client to decide that you are an ok person to talk to.

Note for you readers. All Dr's are not the same and you should never settle on one just because that person was first. Just like looking for a mate they are suppose to match you and you know feel right. My Dr/ counsoler would/ or may not be the best fit for you. I spent a year off and on trying drs till I found one that had what I was looking for. I am not talking about that they tell me what I want to hear. Rather I felt this person earned his degree and not sent in 12 upc ceral box tops and $2 for shipping and handling to get there degree on the wall. All drs/counsolers are not created equal. You have a gut instinct and if it tells you this person is not the fit then they are not your fit. I have more on this if you like to hear more feel free to message me if you like.

OK, I have a bit of a psychodynamic bent, but items 1-3 are things that should happen in at least some therapies. Working through the resistance (figuring out why you need someone to fix you, and what you do with the anger that results from not getting what you want/need) reveals important stuff about how you relate to people and the world. Trying to be a "good patient" by not expressing frustration and anger -- which are normal parts of the process -- may inhibit progress.

Ha, beat ya to it. I cry and begg and admitt. it's completely my time. And i'm loud.....then life is a big picnic. and i take the advice seriously. I always get a huge lift. and experience more reality after with the help. Choices are choices, and you can't stand in your own way.

Thank you for this topic. I asked my husband to read it. He didn't have anything to say afterward and in fact didn't go to his next appointment with our marriage counselor. The three of us will talk about it at our next session and I intend to show her this topic and ask her to help us to understand why he seems to be sabotaging our chance of a healthy relationship.

great suggestions julie. to reword them as positive Do's instead of negative Don'ts for more sensitive indiviuals:

1. take as much responsbility in success as possible
2. stay on track. make the most of your time and remember there are many more ppl needing professional help than helpers. accept the relatively low availablility and high demand
3. be patient. "excersize" your capacity for patience as much as possible. to become a more patient person, ANY frusterating situation is an "oppurtunity", remember that. more patience is just the tip of the iceberg on similar hidden "oppurtunities."
4. minimize uneccessary conflict risks. in terms of stability and productivity, personal relationships are risky. conflicts happen in relationships. you are here for professional help, not a personal friendship. keep professional and personal lives seperate. also applies to religious, political, cultural conflict. minimize the risks by avoiding unncessecary conflicts.
5. stay on track variant. therapists are human and have problems too, but you are paying for their ability to identify and improve YOUR problems. helping you is whats most important, they can get their own professional therapists if theyd like.

My most recent therapist is a clinical licensed social worker, and I just love going to see her. In fact, I look forward to see her for all my appointments. I feel so free telling her my problems, how am feeling about things, and I just let this all out, and vent when I need to, and she is always there for me, always trying to lift me up when I am down, and make me laugh when I am very upset about things. She also gives me great ideas for day trips to encourage me to do more pleasurable activities. I love the fact that whatever I tell her is completely private, and no one will ever know what gets said.

I try to recognize all my emotional, mental and medical problems and get as much help as I can for all of them. And, I am very open to others about my pain problems, without going on and an, and always revert back to my positive thinking which helps with everyone's health and well-being.

Thank you so much for this article as it does affect many of us who have difficulty communicating with a therapist or even be willing to see one in the first place.

Cuddly advice Julie, but we do not trust you. The best advice is coming from the folks commenting below and believe me it's heart warming to see these folks trusting their instincts instead of what is written on websites.
Remember this fact; We have been sexually molested and we are victims of all sorts of hideous assault, from early childhood on, many times by the very people who bore us. We are not to be classed with some one seeking $200 a counselor hour 'couch time' because they just broke up with a steady boyfriend.

Validation. It's all about simple validation, either individually or in groups, publicly or privately with other people who can express how unwanted sex with an unwanted person creates stress to them. Please don't confuse this because it does not resolve with money.

My advice; Always check credentialing of ALL potential practitioners with your states board of registry and NEVER let an individual override your instinct for safety. Therapeutic sexual assault and abuse is a REAL fact.
Tom S. in Tn.

This is advice is rather timely. I first need to get the courage to make the call. And once I do, it is helpful to know because I do want to get the most out of the session. Unfortunately, I don't know if I can get my husband to attend.

We tried to go to one last summer and it was the disaster. The counselor kept looking at his clock the entire time making us feel as if he'd rather be somewhere else. We gave it two tries and gave up.

'4 and 5 ...I knew my therapist for about fifteen years, It was only in the last four that He was my therapist. I already knew too much about him, He already knew too much about me to be objective, I already cared about him more as a friend, than a therapist. The whole thing was a disaster waiting to happen and when it did. It was devistating. NEVER let this happen to you. It's been just as traumatic as anything I have ever endured.

I take issue with the statement that there are 'just a few' bad therapists. In my years I've seen more bad ones than good ones. And, judging by comments I've seen on this site, I'm not the only one.
Sometimes going 'off topic' can bring useful insights into a patients motivation or background. Lists like this make me question the entire psychotherapy profession.

I am troubled by the title, "Five things never to tell your Shrink."
The point of therapy is to be able to tell everything without fear of being judged.
Having said that, I agree - 4 and 5, suggesting "lunch" or asking about the therapist's troubles are absolute 'no-no's'.
I disagree with the first 3, however. "Fix me" may not be what the therapist can do but he/she needs to know what you expect from therapy. Otherwise how can they tell you what they can and cannot do for you.
Random stories may well be an avoidance mechanism. They can also be telling about what you are trying to avoid. For sure, going through your day and telling what you did each and every second is a time waster, but "Oh that reminds me of the time when I was a child and we went to granny's house and...." may be rife with unknown meaning for both the client and the therapist.
Saying "You haven't helped me." lets the therapist know how you are feeling abut the progress of the therapy. How else can they make the suggestions as to seeking out someone else, or that you are not doing the work you need to do?
The author seems to put a majority of the responsibility on the client. If the client was so able to see into themselves and their behavior they most probably would not be seeking therapy.
The therapist is not a clairvoyant. He/she does not know if you feel unhelped, or want to be fixed, as opposed to creating a therapeutic relationship.
The road less taken, i.e. stories that may seem irrelevant on their face, may be very important in helping the therapist to understand you, as a whole person and not merely the one facet of you that you bring to the session or your reason for seeking help.

I have moved 1000 miles away where i had a great therapist. I had been w/ for almost 2yrs. She really helped me get alot straightened out.
After the move, I have found that I needed to go back for awhile and Im not sure how to handle my current counselor. Im usually her late appt and not sure how to relate w/ her because she doesnt say very much at all, and not to sound mean, but she just twirls her hair.. For this reason I havent called to reschedual our appt in seveal weeks. Instead I have spent more time here, and also went to visit the Pastor of the church. Funny, I went to visit him for one hour, and he didnt preach to me about religion, and was able to communicate & give more insight than I have experienced in more than 6 months w/ the counselor. I dont know what to do.
Even the meds Dr I see seems more helpful.. he says he wished he could do therapy w/ me because he knew he could be helpuful, and understanding to my background. However, he can only do meds. Too bad, because both him & the pastor had alot of insight.

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